grey skin, excessive head sweating, bad breath

Hi
My partner is 39 years old, has been smoking since the age of 9 (big thanks to his grandparents for that one) and smokes approx 40-50 a day. He usually has quite grey facial skin and broken blood vessels, very occassional bad breath although his dental hygiene is 1st class and very regular visits to dentist and hygienist. He gets excessive sweating on his head and face particularly when he feels stressed (which is quite often) and sweats in his sleep, I can hear him breathing even when he is resting and he sounds out of breath when he does simple tasks like dressing. We don't sleep in the same room as his snoring is horrific (our next door neighbours have mentioned they can hear him). To top this off, his work environment is dusty and smoky.
Do you think these are symptons of emphysema?
He went to our local doctor a couple of times to monitor his high blood pressure (as was a requirent from our local gym) but she seemed to think everything was normal.

Emphysema? Definitely. And excluding genetic factors, all other cases of emphysema are the result of heavy smoking. Does the doctor thinks everything is normal? No. But if a person smokes 2-3 packs a day for 30 years, doctors know that smoking for those smokers is more important than their lives, as food is for obese people. And doctors don't bother to deal with the "I cannot quit," or with the "I cannot lose weight." They leave that for counselors in clinics that have programs for those issues, and time to lecture and monitor those who decide to be serious and get out of their "denial." And with all the prohibitions on smoking in public buildings, transportation, restaurants, etc, doctors don't talk to smokers about the unhealthy effects of smoking as they did 40-50 years ago, because all the effects of smoking are public knowledge nowadays. The question -in my opinion- that you should be asking now is: Can I save my partner's life? And my humble -but straight, as a "Straightguy" - answer is: Start planning your life ahead without your partner, sooner or later. Pardon me for this gloomy response, but I taught sociology for 20 years, and I know most people in "denial"
end their lives by self-destruction - whether it is alcohol, drugs, smoking, weight, or playing around with deadly hobbies. It is -for them- "a right to passage!"

Emphysema? Definitely. And excluding genetic factors, all other cases of emphysema are the result of heavy smoking. Does the doctor thinks everything is normal? No. But if a person smokes 2-3 packs a day for 30 years, doctors know that smoking for those smokers is more important than their lives, as food is for obese people. And doctors don't bother to deal with the "I cannot quit," or with the "I cannot lose weight." They leave that for counselors in clinics that have programs for those issues, and time to lecture and monitor those who decide to be serious and get out of their "denial." And with all the prohibitions on smoking in public buildings, transportation, restaurants, etc, doctors don't talk to smokers about the unhealthy effects of smoking as they did 40-50 years ago, because all the effects of smoking are public knowledge nowadays. The question -in my opinion- that you should be asking now is: Can I save my partner's life? And my humble -but straight, as a "Straightguy" - answer is: Start planning your life ahead without your partner, sooner or later. Pardon me for this gloomy response, but I taught sociology for 20 years, and I know most people in "denial"
end their lives by self-destruction - whether it is alcohol, drugs, smoking, weight, or playing around with deadly hobbies. It is -for them- "a right to passage!"

Its interesting that you should mention 'denial' and self destruction. Denial is a mechanism he uses for so many areas of his life (which makes the ability to deal with stress in the long term almost impossible). He seems to have a self destruct button, he speaks of it himself ocassionally so he is aware he does it. Most things he does are in excess. If he drinks, he drinks until he passes out, if he goes to a restaurant he has to order everything, if he goes shopping for one shirt, he'll buy 12, if he comes grocery shopping with me, he'll buy more than we need and it gets thrown away... The usual smoking quotes of "noone ever died of smoking" or "there is no such thing as passive smoking" are sometimes spoken but most of the time he'll go outside.
I used to be a smoker so I know how selfish and thoughtless smokers can be. You feel it is your right to smoke whereever and whenever you please regardless of anyone else. I have not smoked for for 2 years now and I was never a heavy smoker like my partner is. I am one of those ex-smokers that hates the smell and complains about it - but I think rightly so!
As for the GP, we seem to be somewhat of an annoyance regardless of what either of us has been there for and we rarely go.
As for encouraging him to give up??? He always sets a date for it in the future, its always tomorrow and tomorrow never comes. He is 40 this week and he said he'd give up then. Smoking is linked so strongly with his identity as a man and his self image, I can't see it happening.